Boutin Y, Jobin M, Bédard P M, Hébert M, Hébert J
Centre de Recherche en Inflammation et Rhumatologie-Immunologie, Centre de Recherche du Centre Hospitalier de l'Université Laval, Laurier, Ste-Foy, Canada.
J Allergy Clin Immunol. 1994 Jun;93(6):1039-46. doi: 10.1016/s0091-6749(94)70053-2.
Passive infusion of beekeepers' plasma was shown to protect patients against systemic reactions occurring during active immunotherapy by mechanisms still to be clarified. It is tempting to speculate that anti-idiotypic antibodies could play a role because they are found in beekeepers' plasma and are involved in the regulation of IgE synthesis.
In this report we studied the effects of passive infusion of a beekeeper's plasma rich in anti-idiotypic antibodies to a patient who experienced systemic reactions to honeybee venom.
We reported, during the days after the infusion, a decrease of clinical sensitivity to the honeybee venom. Indeed, the patient tolerated a cumulative dose of 280 micrograms of venom without adverse reactions. We also observed decreases in skin mast cell and in basophil sensitivity. After the plasma infusion, a modified rush immunotherapy with honeybee venom was initiated in our patient. In the following 76 weeks, increased levels of anti-idiotypic antibodies in the serum of the patient were associated with a diminution of specific antibodies (IgG and IgE) to honeybee venom.
These results suggest a dual role of anti-id in our combined protocol of passive and active immunotherapy: an immediate action on clinical sensitivity along with a decrease of skin mast cell and basophil sensitivity and an immunoregulatory role on specific antibody production.
已表明被动输注养蜂人的血浆可保护患者免受主动免疫治疗期间发生的全身反应，但其机制尚待阐明。有一种推测很诱人，即抗独特型抗体可能起作用，因为它们存在于养蜂人的血浆中并参与IgE合成的调节。
在本报告中，我们研究了向一名对蜂毒有全身反应的患者被动输注富含抗独特型抗体的养蜂人血浆的效果。
我们报告，在输注后的几天内，患者对蜂毒的临床敏感性降低。实际上，该患者耐受了累积剂量为280微克的蜂毒且无不良反应。我们还观察到皮肤肥大细胞和嗜碱性粒细胞敏感性降低。血浆输注后，我们的患者开始了改良的蜂毒快速免疫疗法。在接下来的76周内，患者血清中抗独特型抗体水平的升高与对蜂毒的特异性抗体（IgG和IgE）减少相关。
这些结果表明抗独特型抗体在我们的被动和主动联合免疫治疗方案中具有双重作用：对临床敏感性有即时作用，同时降低皮肤肥大细胞和嗜碱性粒细胞敏感性，以及对特异性抗体产生具有免疫调节作用。
